Maimoatanga Pancreatoduodenectomy me pōauautanga

Ki te rā, mate pukupuku pancreatic ko te momo noa o te mate pukupuku. I roto i te nuinga o te wā, te matapae he ngaahi nunu'a tino kino. I roto i te whakamātautau, kitea kaiwhakaako te aroaro o metastases tuarua, e patu i kiko hauora o te tahi atu whēkau.

Ko te drawback matua o tenei mate ko e kore te reira kitea tetahi tohu o tohumate mate. I roto i tenei take, timata nga pūtau mate pukupuku ki te tupu ki te kaha nui. Ki runga ki te rapunga o te maha nui o tūroro ki metastases kore mahi whawhe hāparapara.

Hangarau pancreatoduodenectomy

Ki resection pancreatoduodenal taea te tūtohutia? tohua pokanga te anake mo aua tūroro i te localization motuhake i roto i te repe taiaki nei pukupuku. mahi tenei pokanga rite te tukanga whakaora.

I mua i te mahi whakahaere i te rata i te tātaritanga whānui o te okana pāngia. Ngā mihi ki whakamātautau ultrasound, me te tātari i te whānuitanga o te tauira mate tohu te momo o te pokanga.

Ki te kei te mate pukupuku kei te i roto i te upoko o te repe taiaki i te takiwā o te whakatuwheratanga o te tau mahani pancreatic ranei, te tākuta mahi pokanga Whipple. I roto i te aroaro o te tukanga mārere i te rohe o te tinana hiku ranei o nga tākuta taiaki mahi pancreatectomy.

Mahi (resection pancreatoduodenal tafa Whipple ranei) i tū tuatahi i roto i te tīmatanga o 1930. Alan tākuta Whipple. I roto i te mutunga o 60-doma o taua tahuti raweketia ko tatauranga nui tiketike.

Ki te rā whakaaro resection pancreatoduodenal te ki kia haumaru rawa. heke auau tahuti nei ki te taumata o te 5%. Ko te hua whakamutunga o te wawaotanga i tika ti'aturi i runga i te wheako ngaio o te tākuta.

He aha te mea te tukanga

Kia whai whakaaro ano tatou e founga ki te whakaputa resection pancreatoduodenal. Ngā wāhanga o te mahi whakaahuatia i raro nei. I roto i te akoranga o taua ngā mahi manawanui mahi tango upoko pancreatic rohe. I roto i te mate kino kawea tango wāhanga o te tau mahani ate me te duodenum. Ki te paetata te mate pukupuku kei te i roto i te kopu, kua whakamana reira he mukunga wāhanga.

I muri tākuta pancreatoduodenectomy honoa toe wāhanga pancreatic. Ate tau mahani tika hono ki te whēkau. Ko te wā o tenei mahi ko e pā ana ki 8 haora. I muri i te mahi i te manawanui ko te maimoatanga tūroro, e tango e pā ana ki 3 wiki.

Laparoscopy Whipple

kawea ana tēnei tikanga o te maimoatanga i roto hoki te tātai i te wāhi o te mate pukupuku. Laparoscopy Whipple tino whakaiti te wā whakanohonoho te manawanui. kawea ana tēnei momo o te pokanga i roto i roto i te aroaro o te tūroro ampullary mate pukupuku.

whakamana pokanga Laparoscopic te roto vahi iti i roto i te puku. Kei te hanga te reira e te tākuta mātanga ki taputapu motuhake hauora. I roto i te mahi tonu whakahaere Whipple vahi puku rahi faahiahia.

A, no te laparoscopic pokanga, tākuta mea te mate toto iti rawa i roto i ngā tukanga hāparapara. mōhio hoki ratou i te mōrea iti o tomo ngā momo o mate.

A, no te te mahi e tika ana Whipple

He he maha o ngā tawhā i raro i taea ki te tino whakatika huru o te manawanui te mahi ko. Ko ētahi o ēnei:

• (Puritia pancreatectomy pancreatoduodenal) pāpaka matepukupuku o te matenga o tari o te repe taiaki.
• Repara i roto i te rohe o te duodenum.
• Cholangiocarcinoma. I roto i tenei take pānga te puku ngā pūtau hauora o te mau irava ate ate.
• mate pukupuku Ampullar. Here Kei te mate pukupuku kei te i roto i te tau mahani pancreatic, e e ate ki te duodenum.

Kei te whakamahia hoki pokanga o tenei momo mo disorders o pukupuku mārire. Ēnei ngā taua mate rite pancreatitis ma'i.

Tata 30% o tūroro mamae tenei momo o te maimoatanga. tātari ratou te wāhi puku i roto i te repe taiaki. Nā ki te kore o tohu pau i roto i te nuinga o te wā puta i roto i te tūroro ki te metastasis ki ētahi atu whēkau. Kawe i te mahi i roto i te akoranga taua o te mate e kore e hanga tikanga.

haamata Pancreatoduodenectomy ki te tātaritanga tika o te tari okana pānga. Tuku tätari hāngai ka whakaatu i te pikitia o te mate.

Te rahi iti o te puku matepukupuku tukua ngā tukanga laparoscopic. Ka rite ki te hua, e kore e taea e tākuta tango i te katoa te wāhi kua pā, ko te kupu kore ai e hāmate te tahi atu whēkau o te kōhao puku.

Hua o te maimoatanga

Te nuinga tūroro ui te pātai taua: he aha nunu'a pankreatoduodnalnoy resection? Neke atu i te te 10 tau o mua, i maturuturu iho te auau te tahuti nei manawanui ki te 4%. Ko te take i tutuki he hua pai i roto i te aroaro o te wheako nui o te tākuta e mahi ana i te mahi.

A, no te taea adenocarcinoma pancreatic Whipple mahi ki te whakaora i te ora e pā ana ki te 50% tūroro. I roto i te ngaro oti o te pukupuku i roto i te pūnaha lymphatic, whakanui i taua mehua te ora o te tūroro e rave rahi taime.

I muri i te mahi whakaritea te manawanui e ki te akoranga o te iraruke me hahau. Ko te tika tenei i roto i te tikanga ki te whakangaro i te pūtau mate pukupuku horapa ki ētahi atu whēkau.

maimoatanga atu i muri i te pokanga contraindicated te i roto i ngā tūroro ki te aroaro o te puku Koló, me te ki whakarereke neuroendocrine.

Pancreatoduodenectomy: technique hāparapara

I roto i te tukanga hāparapara tango te nuinga o te tinana, i te mea te kawenga mō te secretion o taiāki. I roto i te tahuri, e tauturu te reira te whakahaere i te taumata o te huka i roto i te pūnaha toto. resection Motunga tino whakaiti te hanga o te taiāki. Ka rite ki te hua, te nuinga o tūroro tino whakanuia ana te tūponotanga o te whakawhanake taua mate rite te mate huka.

He tino haria ki tenei momo o te mate tūroro ki ngā taumata huka toto tiketike. taumata kūhuka i Pūnoa i roto i te manawanui ki te ngaro pancreatitis ma'i matemate te whakaiti i te whanaketanga o te mate huka.

I te mutunga o te tukanga whakanohonoho i te rata haere taunaki ana te kai. Mai i kia te kai kia waho rawa fatty me ngā kai tote. E mea pinepine, i muri i taua wawaotanga, i ātete ki ngā kai reka maha tūroro. I roto i tenei take, contraindicated tona whakamahinga te.

Pōauautanga i te pokanga Whipple

Tenei momo o te maimoatanga he mōrea ka makona ratou nui o pōauautanga. Te wātea o te wheako ngaio o te tākuta tino whakaiti te takanga o tetahi raruraru. raruraru tūwātea ngā:

• Ko te ahua o te fistula pancreatic. I roto i te pokanga hono te tākuta te repe ki te tari intestinal. Soft kikokiko he tui tinana pancreatic ārai whakaora tere. I roto i tenei wā, i reira te mea he mate o wai pancreatic.
• pāpāngia Motunga o te puku. I muri i te mahi whakaritea te manawanui ko te werohanga i roto i te akoranga IV. Ko te tika tenei i roto i te tikanga ki te whakahoki mahi noa o te puku.

Meals i muri i pancreatoduodenectomy kia tika, nga peu kino katoa e hiahia ana koe ki te whakakore. I roto i te hanganga ture ki te kupu tohutohu katoa o te tangata kei te āta hoki mai ki te ora noa.